Provider Demographics
NPI:1447031398
Name:REEVES, ERICA DESHUN (LPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DESHUN
Last Name:REEVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7772 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-6869
Mailing Address - Country:US
Mailing Address - Phone:470-234-5070
Mailing Address - Fax:
Practice Address - Street 1:7772 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-6869
Practice Address - Country:US
Practice Address - Phone:470-234-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012380101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health